Jim Burkhart, president and CEO of Shands Jacksonville Medical Center, will start in the same post at the bay area's largest hospital in March, retiring CEO Ron Hytoff announced Wednesday.

Burkhart will take over a 1,018-bed institution pinched by soaring costs and declining government contributions. It also has weathered relationship issues with its primary teaching partner, the University of South Florida medical school.

His agenda will include mapping out a business strategy for Tampa General, which in an era of hospital mergers and acquisitions soon could become the region's last independent general hospital.

"The future of health care is that you have to have relationships," Burkhart, 58, said Wednesday in a phone interview. "That doesn't mean mergers necessarily. It can mean a hundred different things. What it does mean is you have to figure out how to align yourself with other players where it makes sense."

In a Tennessee-inflected twang, the former military officer highlighted his strength in working "to make all ships rise."

His success in a similar academic medical setting — Shands Jacksonville is a private, not-for-profit teaching hospital affiliated with the University of Florida — impressed Tampa General leaders.

"He has tremendous teaching hospital experience, which I like. That experience has occurred over many years," said David A. Straz Jr., chairman of the Florida Health Sciences Center Inc., Tampa General's governing board.

"I like the fact that he has a very good relationship with his university medical school," Straz added.

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Filling the top slot at Tampa General has been a critical concern since Hytoff, 67, announced his retirement in June. He remained the hospital's leader through the search for his replacement.

Hytoff has been CEO since February 2000. He has helped the hospital to become more financially stable, overseeing considerable renovation and expansion at its main campus on Davis Islands, near downtown.

"I have known Jim for almost 10 years and am very confident he will lead TGH in an exemplary fashion," Hytoff wrote in an email Wednesday to hospital employees. He declined to be interviewed.

But Hytoff has clashed with Dr. Stephen Klasko, the medical school dean at USF.

Rumors of the strains were so rampant that last month Hillsborough County commissioners urged the two institutions to work on their relationship.

Klasko, who served on the search committee, sent Burkhart a congratulatory email Wednesday, noting that the future of both organizations was bright — but "together the brightness increases exponentially.''

Wednesday, Klasko elaborated. "Given the economics of health care, where even small changes matter, we're about as tied at the hip as two organizations can get at a difficult time," he said.

Frank Morsani, the philanthropist whose name is on the USF medical school, said he doesn't know Burkhart but has heard only positive remarks about him from university officials. Asked about the relationship between Hytoff and Klasko, he demurred.

"I think sometimes change is important," he said. "I think both parties can be pleased they have a new executive."

Following a 10-year clinical affiliation agreement, USF and TGH this year renewed for just one year, attributing the short term to the hospital's pending leadership change. Burkhart said he hopes to discuss a longer-term partnership.

That would be welcomed by community leaders, including Tampa Mayor Bob Buckhorn.

"Neither one of them can afford to survive without the other," said Buckhorn, whose wife, Dr. Catherine Lynch, is a USF-TGH physician. "The two agencies are going to succeed together, or they're going to fail alone."

"USF's not in the position to build its own teaching hospital, and Tampa General needs the USF physician group to manage patient care," he added.

Hillsborough Commissioner Sandy Murman said she was pleased with Burkhart's selection.

"Coming from another teaching hospital will really help with USF and get everything back on track," she said.

Straz wouldn't say if Burkhart's involvement with Shands might mean Tampa General could forge a relationship with the University of Florida, though he acknowledged the idea could be the subject of a lot of speculation.

"Our partner right now is USF," he said.

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Burkhart has been president and CEO at Shands Jacksonville since 2010, after serving as president and administrator since 2003.

He came to Shands Jacksonville in 2001 as part of a consulting group charged with turning around the financial performance of a hospital teetering on bankruptcy. He is credited with stabilizing its finances, although challenges remain. In 2011, Shands Jacksonville lost money, posting an operating margin of minus 0.4 percent, according to the most recent state records. Tampa General stayed out of the red, with an operating margin of 0.1 percent.

Both hospitals are considered safety-net institutions for the large numbers of poor and uninsured patients they treat. Both also operate expensive Level 1 trauma centers, seeing the most critically injured patients.

In Jacksonville, Burkhart worked to open clinics that he said helped reduce visits to the hospital's emergency department from 125,000 per year to 80,000.

"You should take care of patients in the lowest-cost setting possible," he said.

Dr. David Guzick, president of UF&Shands Health System, said Burkhart routinely met with UF medical leaders, forging close ties with the faculty.

Guzick, who is also chairman of the Shands Jacksonville board, called Burkhart a "good listener," who expresses his opinion "but doesn't do it to the point he's overpowering."

Earlier in his career, Burkhart, a Tennessee native, was president of Fort Sanders Park West and Regional Medical Centers in Knoxville, operating two medical centers with 900 beds and 3,000 employees.

Married with three grown children, Burkhart said he is looking forward to living in an area where he vacationed as a child. His wife, Tina, a baseball fan, already is a frequent visitor during spring training.

At Tampa General, Burkhart will lead a hospital that has roughly one-third more beds and staff than Shands Jacksonville.

"My goal would be to come here and stay — until it's time for me to move off into the sunset," he said.

Times researcher Natalie Watson contributed to this report. Letitia Stein can be contacted at lstein@tampabay.com; Jodie Tillman at jtillman@tampabay.com

. Biography

Jim Burkhart

Age: 58

Education: Undergraduate degree from the University of Tennessee and master's and doctorate of science in health administration at the University of Alabama at Birmingham.

Most recent job: President and CEO of Shands Jacksonville Medical Center

Family: Married to Tina Burkhart, with three grown children, ages 32 to 25